Quality Indicators

OUR QUALITY INDICATORS

Quality indicators digitally demonstrates the level of success of the institutions in specific areas. Health allows the monitoring of quality indicators in many fields. As Anadolu Medical Center we shall be sharing in these pages the various quality indicators and their consequences in the fields of "Patient Satisfaction" and "Clinical Quality".

For each quality indicator shared, you will be able to find in the further sections what that means, why it is measured, according which method it is measured, what our results are and the status of such results as compared to the international results (benchmark / criteria).

Regarding "Hospital Patient Satisfaction" below stated 11 quality indicators are shared:

• General Satisfaction
• Being Recommended
• Nurse Communication
• Physician Communication
• Instant Support of the Employees
• Information on Drug Used
• General Cleaning
• Silence
• Getting information with regards to how the support shall be received in case of need in the aftermath of discharge
• Getting Information with respect to possible symptoms and problems in the aftermath of discharge

HOSPITAL PATIENT SURVEYS

Why do we monitor?

Increasing patient satisfaction which is among the essential goals of health institutions sets forth to what extent the expectations and requirements of the patients could be met. Furthermore such feedback is used as an important measurement tool in the quality development of the institutions as well.

Satisfaction of the patients and their opinion pertaining to the experience they had in the hospital are accepted as important indicators of the service quality. In order to be successful in such area it is required to resort to the opinions and experiences of the patients and perceive their expectations accurately.

Which Method Do We Apply?

HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems), is a survey used for measuring patient experiences at each hospital in the United States of America. It is compulsory for each hospital in the USA to use such survey developed by CMS (the Centers for Medicare and Medicaid Services) that is to say USA health insurance establishments. Such survey the validity and reliability analyses whereof have been made is as well used at Anadolu Medical Center for the purpose of measuring patient experience and satisfaction.

It is possible to see and compare the results of defined performance indicators of entire USA hospitals through Hospital Compare webpage. As Anadolu Medical Center the reason why we use HCAHPS Hospital Patient Survey is to be able to make such comparisons.

The results given for entire indicators which you can see in these pages as well contain John Hopkins Medicine (JHM) and United States of America entire hospitals comparisons which are included in Hospital Compare web-pages in defined periods.

The basic reason why we make the comparison with Johns Hopkins and USA average is that adequate data paving the way for making a comparison is not yet available in Turkish Health Care System.

What Do We Measure?

• General Satisfaction
• Being Recommended
• Nurse Communication
• Physician Communication
• Instant Support of the Employees
• Information on Drug Used
• General Cleaning
• Silence
• Getting information with regards to how the support shall be received in case of need in the aftermath of discharge
• Getting Information with respect to possible symptoms and problems in the aftermath of discharge

a. General Satisfaction

How Do We Monitor?

It is measured by considering the answers to below stated question which is included in "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• If you are required to give a grade to our Hospital between 0 and 10, which grade will you give? (0 indicates the worst and 10 the best)

The results are being calculated in accordance with the HCAHPS method. In this method the number of surveys wherein the highest score that is to say 9 or 10 was given, is proportioned to the total number of the answers given to such question. The result obtained is the "General Satisfaction" rate.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

b. Being Recommended

How Do We Monitor?

It is measured by considering the answers to below stated question which are included in "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Would you recommend our hospital to your family and your relatives?

The results are being calculated in accordance with HCAHPS method. In this method the number of surveys wherein the highest score that is to say the answer of "I would definitely recommend" was given, is proportioned to the total number of the answers given to such question. The result obtained is the "Recommendation" rate.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

c. Nurse Communication

How Do We Monitor?

It is measured by considering the answers to below stated questions which are included in "Our Nurses" section of "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Did our nurses treat you respectfully and kindly during the period of your stay in our hospital?
• Did our nurses listen to you carefully during the period of your stay in our hospital?
• Did our nurses explain you the issues pertaining to your care in a manner you could understand during the period of your stay in our hospital?

The results are being calculated in accordance with HCAHPS method. In this method the result of every question is calculated by proportioning the number of surveys wherein the highest score that is to say the answer of "always" was given, to the total number of the answers. "Nurse Communication" rate is determined by taking the arithmetical average of the results yielded.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

d. Physician Communication

How Do We Monitor?

It is measured by considering the answers to the below stated questions which are included in "Our Physicians" section of "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Did our physicians treat you respectfully and kindly during the period of your stay in our hospital?
• Did our physicians listen to you carefully during the period of your stay in our hospital?
• Did our physicians explain you the issues pertaining to your illness and treatment in a manner you could understand during the period of your stay in our hospital?

The results are being calculated in accordance with HCAHPS method. In this method the result of every question is calculated by proportioning the number of surveys wherein the highest score that is to say the answer of "always" was given, to the total number of the answers. "Physician Communication" rate is determined by taking the arithmetical average of the results yielded.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

e. Instant Support of the Employees

How Do We Monitor?

It is measured by considering the answers to below stated questions which are included in "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Did our nurses immediately come to your room when you pressed on the nurse call button during the period of your stay in our hospital?
• Did our health personnel immediately help you when you called for help to go to the toilet or to use bedpan during the period of your stay in our hospital?

The results are being calculated in accordance with HCAHPS method. In this method the result of every question is calculated by proportioning the number of surveys wherein the highest score that is to say the answer of "always" was given, to the total number of the answers. "Immediate Assistance of the Employees" rate is determined by taking the arithmetical average of the results yielded.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

f. Information on Drug Used

How Do We Monitor?

It is measured by considering the answers to below stated question which are included in "Your experiences in the Hospital" section of "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Before the start of a new drug, did our health personnel explain for which purpose such medication is administered in a manner you could understand?

The results are being calculated in accordance with HCAHPS method. In this method the number of surveys wherein the highest score that is to say the answer of "always" was given, is proportioned to the total number of the answers given to such question. The result yielded is the "Information on Drug Used" rate.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

g. General Cleaning

How Do We Monitor?

It is measured by considering the answers to below stated question which are included in "Our Hospital Environment" section of "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Were your room and bathroom cleaned during the period of your stay in our hospital?

The results are being calculated in accordance with HCAHPS method. In this method the number of surveys wherein the highest score that is to say the answer of "always" was given, is proportioned to the total number of the answers given to such question. The result obtained is the "General Cleaning" rate.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

h. Silence

How Do We Monitor?

It is measured by considering the answers to below stated question which are included in "Our Hospital Environment" section of "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Were your room and its surroundings silent during the period of your stay in our hospital?

The results are being calculated in accordance with HCAHPS method. In this method the number of surveys wherein the highest score that is to say the answer of "always" was given, is proportioned to the total number of the answers given to such question. The result obtained is the "Silence" rate.

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

i. Getting information with regards to how the support shall be received in case of need in the aftermath of discharge

How Do We Monitor?

It is measured by considering the answers to below stated question which are included in "While Leaving our Hospital" section of "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• Were you given information during the period of your stay in our hospital by our health personnel regarding what you should do in case you need any kinds of help after you were discharged?

The number of surveys wherein the answer of "yes" was given, is proportioned to the total number of the answers given to such question. The result obtained is the rate of "Getting information with regards to how the support shall be received in case of need in the aftermath of discharge".

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

j. Getting Information with respect to possible symptoms and problems in the aftermath of discharge

How Do We Monitor?

It is measured by considering the answers to below stated question which are included in "While Leaving our Hospital" section of "Hospital Patient Satisfaction Survey" submitted to the patient in the aftermath of the discharge of patients.

• During the period of your stay in our hospital were you given information in writing about the symptoms or health problems that you should be aware of after being discharged?

The number of surveys wherein the answer of "yes" was given, is proportioned to the total number of the answers given to such question. The result yielded is the rate of "Getting information with respect to possible symptoms and problems in the aftermath of discharge".

Our Goal:

For July 2020 – March 2021 period the results for Anadolu Medical Center, Johns Hopkins Medicine and the United States of America (USA) are given below.

EFFICIENCY INDICATORS

a. Amount of Medical Waste by the Inpatient Days

Why do we monitor?

Healthcare organizations produce different types of waste while providing care for their patient. Medical wastes, hazardous wastes, domestic wastes and recycled wasted are main categories. Correct separation on site, contacting with competent waste recycling companies, making projects to decrease total amount of wastes and conducting awareness campaigns have important role to decrease the negative effects on the environment.

For this purpose, Anadolu Medical Center supports all efforts for correct separation of wastes and decreasing the amount of waste. Organization monitors the amount of different types of produced wastes. Especially efforts to decrease total amount of medical waste is important both for the organization and environment. These projects help to comply with our responsibilities against the environment. Moreover they help to decrease the cost to remove medical waste and this creates efficiency.

How Do We Monitor?

Total amount of medical waste is divided by the total number of inpatient days for that time period. The result’s unit is kg/inpatient days.

Our Goal:

It was seen that the increase in the amount of medical waste in 2020 and 2021 was the effect of the pandemic.

CLINICAL INDICATORS

Regarding "Clinical Quality" below stated 2 performance indicators are shared:

• Application Rate of Anticoagulant (VTE Prophylaxis) within 24 Hours as of Hospitalization or Surgery
• Effective communication: Standard method of handoff is used and documented for transfer of care from Emergency Department to next level of care

a. Application Rate of Anticoagulant (VTE Prophylaxis) within 24 Hours as of Hospitalization or Surgery

Why do we monitor?

Clot formation in the veins (venous thromboembolism - VTE) and consequent clot formation in the blood vessels of the lung (embolism) in hospitalized patients can lead to serious complications and it can sometimes result with death.

Risk assessment is conducted in order to identify the patients who carry such risk. In order to minimize the risk specified, it is necessary to timely initiate appropriate actions and anticoagulant applications (thromboprophylaxis). In case there are patients who were not started anticoagulant applications, the reason why such patients were not provided with such treatment should be documented.

In patients who were started anticoagulant applications, the administration should be given in accordance with the determined risk score and the improved clinical guidelines.

How Do We Monitor?

In this clinical indicator, the records of 70 patients randomly selected from among hospitalized patients are examined. It is evaluated whether a VTE risk analysis has been performed within 24 hours for such patients and in case it was performed; whether appropriate anticoagulant applications have been started. The percentage of those who were performed the appropriate application is monitored monthly.

Our Goal:

b. Effective communication: Standard method of handoff is used and documented for transfer of care from Emergency Department to next level of care

Why do we monitor?

Breakdown of communication between healthcare providers may result in adverse events. Practices are put in place to improve effective communication and thus, ensure patient safety.

Being aware that handover communication is of paramount importance, we monitor accurate and complete handover communication between the members of the care team as an indicator.

How Do We Monitor?

For this clinical indicator, we review the medical records of patients who have been moved from the emergency department to other clinical areas of the hospital. We focus on the completeness of the patient transfer form that must be included in patient’s file. The completed form is checked to see whether handover communication was documented accurately.

Our Goal: